42 CFR § 405.920 - Initial determinations.

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After a claim is filed with the appropriate contractor in the manner and form described in subpart C of part 424 of this chapter, the contractor must -

(a) Determine if the items and services furnished are covered or otherwise reimbursable under title XVIII of the Act;

(b) Determine any amounts payable and make payment accordingly; and

(c) Notify the parties to the initial determination of the determination in accordance with § 405.921.